As you likely already know, long-term disability benefits (LTD) that your employer provides through an insurance company can help to offset lost income if you become injured or develop an illness. However, although these policies are usually beneficial, they often contain exclusions you might not be aware of.
Sometimes these exclusions can prevent you from receiving the benefits you deserve, or you might only get a reduced sum instead of the full amount you’re owed. That’s why you must know more about the common exclusions in an LTD policy so that you don’t lose out on any benefits.
Yet, at Bartolic Law, we understand that not everyone can understand an insurance policy’s technical and legal language. That’s why we help our clients determine their LTD policy exclusions and help them fight an insurance company if their benefits are being withheld because of these exclusions.
Before we look at the common LTD policy exclusions, we want to briefly explain what an LTD exclusion is. Often many people don’t look too closely at the fine print when signing their policy paperwork and might miss the list of exclusions while looking at coverages and monthly premiums.
Ultimately, a disability insurance exclusion in your policy outlines the situations where your insurance company will not pay you a monthly benefit.
Below we have briefly discussed four common LTD policy exclusions you might encounter when you try to receive benefits. A qualified lawyer can help you potentially receive these benefits despite them being excluded or fight to prove that you don’t fall within these exclusion categories.
Many people suffer from mental health problems; fortunately, in recent years, the stigma surrounding them is improving in the workplace. Yet, unfortunately, many insurance policies still exclude mental health conditions from LTD benefits.
Often mental health issues like depression, anxiety, bipolar disorder, and post-traumatic stress disorder won’t be covered in an LTD insurance policy. However, a few policies might cover mental health conditions but only for a short period of time.
If you suffered from health conditions or a disability before your LTD insurance policy went into effect, these conditions or disabilities would likely be classified as pre-existing conditions. Typically pre-existing conditions are not covered by LTD policies and are excluded.
In most instances, insurance companies will not cover any conditions or disabilities treated within three months prior to you undertaking the LTD policy. Common pre-existing conditions often excluded include cancer, epilepsy, asthma, depression, sleep apnea, diabetes, and lupus.
In recent years drug addiction and alcoholism exclusions are becoming increasingly common in LTD policies. Additionally, if a policy covers drug addiction and alcoholism, it is only for a limited time. This means a person who has been disabled because of these conditions will receive benefits for a shorter time, with the time frame often no more than two years.
In most cases, self-reported conditions and symptoms are applied to those suffering disabilities caused by fatigue, pain, and cognitive dysfunction. Many LTD policies exclude these self-reported conditions and symptoms. However, those still covering self-reported conditions will limit the duration of LTD benefits for people suffering from chronic pain and conditions like Lyme disease, migraines, fibromyalgia, tinnitus, and arthritis.
If you face exclusions in your LTD policy that you feel are unjust or unfair, you should consider speaking with a Chicago long-term disability attorney. At Bartolic Law, we work with our clients to ensure they get the LTD benefits they are entitled to. We’ll do everything possible to ensure you don’t experience a denied claim or reduced monthly payments. All you need to do to get the ball rolling is contact us, and we will schedule you for a consultation.